Circumcision

Male circumcision is evidently both the oldest and the most widespread surgical operation. It was practiced among several ancient Near Eastern cultures, but scholars have differed as to which of these first introduced the practice and how it spread. According to the Bible (Genesis 27:24–25), the first individuals to be circumcised at God's command were Abraham, who performed the procedure upon himself at the age of ninety-nine, and his son Ishmael, who was thirteen when he entered the "covenant." Voltaire, however, in his 1764 Philosophical Dictionary famously asserted that the Israelites had adopted circumcision from the Egyptians ("who revered the instrument of generation") rather than vice versa. "Would a master," he asked, "adopt the principle badge of his thieving and fugitive slave?" Whatever the direction of influence (if any), Israelite circumcision was performed on infants at the age of eight days, whereas among the Egyptians the rite seems to have been reserved for initiation into manhood, or possibly for prenuptial ceremonies.

Religious Circumcision

Since Biblical times, Jews have continued to circumcise male infants on the eighth day, but Muslims, among whom the rite (though not mentioned in the Qur'an) also became standard, have no set date for its performance, often waiting until several years after birth but rarely beyond the onset of PUBERTY. Whereas Jewish circumcision involves not only the excision of the outer part of the foreskin, but also a slitting of its inner lining (to facilitate the total uncovering of the glans), the Islamic rite calls only for the first procedure.

Female circumcision, which is also widely practiced in the Muslim world (especially in Egypt and other parts of Africa), always involves some cutting of, but not necessarily removal of, the clitoris, and sometimes cutting of labial tissue as well. Most proponents of female circumcision have seen it as a way of minimizing female sexual desire, thus ensuring the protection of a girl's virginity and her family's honor. Similar arguments have been made in favor of male circumcision, notably by the medieval Jewish philosopher Maimonides.

In Hellenistic times, many Jews who were influenced by Greek physical culture and wished to participate in nude athletic events underwent the operation of epispasm in order to conceal the shameful signs of their circumcision. It was under the Seleucid monarch Antiochus Ephiphanes (175–164 B.CE.), a champion of intense Hellenization, that Jews were first prohibited from practicing circumcision. During the period of Roman rule in Palestine, circumcision was again prohibited by the emperor Hadrian, although scholars differ as to whether this was a cause or result of the Bar-Kokhba rebellion in the early second century. Although, following the teachings of Paul, most Christian sects abolished the practice of circumcision, it continued to be observed by Christian Ethiopians and by Egyptian Copts.

Circumcision is described in the Bible as a mark of the covenant between God and the Israelites, but later Jewish interpreters provided additional explanations for the practice. Philo of Alexandria, in the first century, saw the excision of the foreskin as a symbol for the excision of sensual desires, and Maimonides, in his Guide of the Perplexed, saw in circumcision a moral purpose, for "it weakens the faculty of sexual excitement and sometimes diminishes the pleasure." Some medieval Jewish exegetes stressed that Isaac was conceived only after Abraham purified his phallus through the act of circumcision. In Jewish mystical thought, circumcision was seen as having removed the barrier between Abraham and God, allowing him (and his descendants) a vision of the divine.

The seventeenth-century philosopher Baruch Spinoza argued that the sign of circumcision was so integral to Jewish identity that "it alone" could preserve the Jews as a nation forever. A number of early modern travellers, such as Michel de Montaigne and Thomas Coryate, witnessed Jewish circumcisions during their sojourns abroad, sometimes describing the ceremonies and their accompanying festivities in considerable ethnographic detail. Among artistic renditions of the rite, perhaps the best known is Romeyn de Hooghe's Circumcision in a Sephardic Family, executed in 1668.

Medical Circumcision

Some German-Jewish advocates of religious reform sought to nullify the rite of circumcision–a proposal first advanced in 1843 but ultimately rejected by the Reform movement. During the second half of the nineteenth century, some medical researchers in England and the United Sates advanced claims concerning the curative or prophylactic merits of circumcision, beginning with Nathaniel Heckford's 1865 Circumcision as a Remedial Measure in Certain Cases of Epilepsy, Chorea, etc. The most ardent advocate of circumcision on medical grounds was the prominent New York physician Lewis Sayre, who came to be known as the "Columbus of the prepuce" and who for three decades, beginning with his 1870 article in Transactions of the American Medical Association (of which he became president in 1880), argued persistently that serious orthopedic diseases could be prevented by early surgery on the foreskin.

During the latter half of the nineteenth century, some physicians who crusaded against MASTURBATION, such as the American pediatrician M. J. Moses, saw it as "one of the effects of a long prepuce." Similarly, in his 1891 History of Circumcision from the Earliest Times to the Present (more a polemic than a history) the California physician Peter Charles Remondino wrote that "the practice [of masturbation] can be asserted as being very rare among the children of circumcised races." It was his view that a wide variety of ailments, including asthma, penile cancer, and syphilis, could be avoided through early circumcision, and that consequently "life-insurance companies should class the wearer of the prepuce under the head of hazardous risks." By the end of the nineteenth century, male circumcision at birth became standard procedure in the United States.

During the 1970s, however, first the American Academy of Pediatrics and then the American College of Obstetricians and Gynecologists issued reports concluding that routine circumcision was not warranted. Moreover, by 1976 the influential pediatrician BENJAMIN SPOCK, who had originally endorsed circumcision, changed his mind, asserting that it was "unnecessary and at least mildly dangerous." In 1988, appearing on ABC's Nightline, he went even further: "I'magainst circumcision…. If I had a baby now … I certain-ly would not want him circumcised. And if parents ask me, I would lean in the direction of saying, 'Leave his poor little penis alone.'"